Abstract
Objective : At our laboratory, we decided to separate atypical squamous cells of undetermined significance (ASC-US) into ASCUS-not otherwise specified (ASCUS-NOS), associated with a low incidence of high-risk HPV infection, and ASCUS-favor dysplasia (ASCUS-D), associated with a high frequency of high-risk HPV infection. Our goal was to objectively distinguish between ASCUS-NOS and ASCUS-D using a scoring system.
Study Design : We reclassified 122 Papanicolaou smears labeled as ASC-US based on our original scoring system and compared the results with the original diagnoses and the rates of high-risk HPV in each category.
Results : Of the 122, 23 cases were classified into NILM, and none of these cases was associated with high-risk HPV infection. Thus, the rate of high-risk HPV-positive infection increased from 34.4% to 42.4% in the ASC-US cases, including 15.2% in cases of ASCUS-NOS, and 56.1% in cases of ASCUS-D.
Conclusion : Our recategorization of ASC-US cases into ASCUS-NOS and ASCUS-D using a simple scoring system for Papanicolau smears resulted in a significant difference in the rate of association with high-risk HPV infection between those subcategories. However, we could not exclude a few HPV-positive cases even in ASCUS-NOS cases after the reclassification. Thus, we concluded that it is preferable to make wide use of the ASC-US subcategories, including ASCUS-NOS, and analyze the subsequent HPV-DNA tests in the first screening for cervical cancer.
